Chemoprevention of hepatocellular carcinoma in aflatoxin endemic areas

Thomas W Kensler, Patricia Egner, Jin Bing Wang, Yuan Rong Zhu, Bao Chu Zhang, Pei Xin Lu, Jian Guo Chen, Geng Sun Qian, Shuang Yuan Kuang, Peta E. Jackson, Stephen J Gange, Lisa Paula Jacobson, Alvaro Munoz, John Davis Groopman

Research output: Contribution to journalArticle

Abstract

Hepatocellular carcinoma is one of the most common cancers worldwide. Infection with hepatitis B virus and exposure to aflatoxins in the diet act synergistically to amplify risk. From a public health perspective, hepatitis virus vaccination programs and efforts to both reduce aflatoxin exposures and to attenuate the toxicological consequences of unavoidable exposures should have major impacts on the global incidence of this disease. Experimentally, aflatoxin-induced hepatocarcinogenesis can be inhibited by over a score of different chemopreventive agents with multiple mechanisms of action. One agent, oltipraz, is a potent inducer of phase 2 enzymes involved in the detoxication of carcinogens including aflatoxin. A second agent, chlorophyllin, impedes the bioavailability of carcinogens by forming molecular complexes and enhances their elimination in the fecal stream. This review highlights the findings of recent randomized clinical trials with oltipraz and chlorophyllin conducted in individuals exposed to dietary aflatoxins and at high risk for development of liver cancer. Both chemopreventive agents modulated levels of aflatoxin biomarkers in the study participants in manners consonant with protection. Although pharmacological approaches establish proof of principle and help identify key molecular targets for interventions, food-based approaches that also use these molecular targets may be the most practical for widespread application in high-risk populations.

Original languageEnglish (US)
JournalGastroenterology
Volume127
Issue numberSUPPL.
DOIs
StatePublished - Nov 2004

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Aflatoxins
Chemoprevention
Hepatocellular Carcinoma
Carcinogens
Hepatitis Viruses
Liver Neoplasms
Hepatitis B virus
Toxicology
Biological Availability
Vaccination
Randomized Controlled Trials
Public Health
Biomarkers
Pharmacology
Diet
Food
Incidence
Enzymes
Infection
Population

ASJC Scopus subject areas

  • Gastroenterology

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Chemoprevention of hepatocellular carcinoma in aflatoxin endemic areas. / Kensler, Thomas W; Egner, Patricia; Wang, Jin Bing; Zhu, Yuan Rong; Zhang, Bao Chu; Lu, Pei Xin; Chen, Jian Guo; Qian, Geng Sun; Kuang, Shuang Yuan; Jackson, Peta E.; Gange, Stephen J; Jacobson, Lisa Paula; Munoz, Alvaro; Groopman, John Davis.

In: Gastroenterology, Vol. 127, No. SUPPL., 11.2004.

Research output: Contribution to journalArticle

Kensler, Thomas W ; Egner, Patricia ; Wang, Jin Bing ; Zhu, Yuan Rong ; Zhang, Bao Chu ; Lu, Pei Xin ; Chen, Jian Guo ; Qian, Geng Sun ; Kuang, Shuang Yuan ; Jackson, Peta E. ; Gange, Stephen J ; Jacobson, Lisa Paula ; Munoz, Alvaro ; Groopman, John Davis. / Chemoprevention of hepatocellular carcinoma in aflatoxin endemic areas. In: Gastroenterology. 2004 ; Vol. 127, No. SUPPL.
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